Provider Demographics
NPI:1578147575
Name:DANIELSON, ROBIN GABRIEL (APRN MSN FNP-C)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:GABRIEL
Last Name:DANIELSON
Suffix:
Gender:M
Credentials:APRN MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 NOTTOWAY DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-2273
Mailing Address - Country:US
Mailing Address - Phone:469-810-9717
Mailing Address - Fax:
Practice Address - Street 1:2212 NOTTOWAY DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-2273
Practice Address - Country:US
Practice Address - Phone:469-810-9717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC003680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily